• Aman Verma, Parshwanath Bondarde, Anil Kumar, Siddharth Sekhar Sethy, Aakash Jain, Vibhor Abrol, Kaustubh Ahuja, and Pankaj Kandwal.
• Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India.
• Spine. 2025 Jan 30.

Study DesignSystematic review and meta analysis.ObjectiveTo assess the safety and efficacy of staged versus same-day spinal fusion surgeries in Adult spinal deformity (ASD).BackgroundASD surgeries are associated with high complication rates, ranging from 10% to 40%. Among the strategies to enhance safety, staging the procedure into two smaller procedures has been evaluated as an effective alternative.MethodsA systematic literature review following PRISMA guidelines was conducted using PubMed, Cochrane, Scopus, and Embase. Studies comparing staged and same-day spinal fusion for ASD were included. Perioperative data, patient-reported outcomes (ODI, SRS), radiological outcomes, and complication rates were analysed. The extracted data was analyzed and forest plots were generated to draw comparisons between the staged and the same day groups.ResultsEleven studies, including 1323 patients (541 staged, 782 same-day) were analyzed. Staged surgeries were associated with longer operative time and length of hospital stay. There was no significant difference in estimated blood loss, clinical and radiological outcomes, or overall complication rates between groups. However, venous thrombo-embolism (VTE) rates were significantly higher in staged surgeries (odds ratio=4.33). In the staged group, surgical site infections was the most common complication with a rate of 10.5%, whereas neurological complications were the most frequent group of complications in same-day group.ConclusionStaged surgeries for ASD result in longer operative time, length of hospital stay and increased VTE risk but show similar efficacy in clinical and radiological outcomes compared to same-day surgeries. Careful patient selection is crucial to balance risks and optimize outcomes in ASD surgical planning.Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

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